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Cardiol J. 2018;25(4):495-500. doi: 10.5603/CJ.a2017.0136. Epub 2017 Nov 23.

Anxiety disorders and stressful events in Takotsubo syndrome.

Author information

1
Department of Clinical and Experimental Medicine, University of Parma, Italy. moderatoluca@gmail.com.

Abstract

BACKGROUND:

Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. The aim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.

METHODS:

Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.

RESULTS:

Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).

CONCLUSIONS:

In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.

KEYWORDS:

Takotsubo syndrome; anxiety disorders; psychiatric disorders; stress cardiomyopathy; stressful events

PMID:
29168538
DOI:
10.5603/CJ.a2017.0136
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